Benadryl®: Pros & Cons

Have you heard parents say, “Just give them some Benadryl®” when they refer to helping kids relax, calm down, sleep, etc.? Well, I can tell you I get many questions about this, so I thought it would help to list some common questions and answers about this drug. Diphenhydramine, brand name Benadryl®, is one of the oldest and most frequently used over-the-counter medications for children. Diphenhydramine, an anti-histamine, counteracts the effects of histamine throughout the body, which include itching, runny nose, sneezing and hives. It is not a very selective medication and has other unintended side effects, which often confuse parents. Here are some examples of common questions:

Can Benadryl make my child sleepy? Yes, one of the main side effects is sedation. This can make many children very drowsy, to the point of falling asleep. In addition, sedation can cause lingering confusion and significantly impair gross motor and even affect learning abilities. This can be a big problem when it comes to school performance.

My child becomes hyperactive with Benadryl®. Is this normal? Hyperactivity occurs in roughly 10-15% of children as sort of an opposite effect. The only way to know if your child will react this way is by giving it to them. Tip: Do not give them Benadryl® for the first time right before you board a plane or get in a car for a long road trip!

I often use Benadryl® to help my child go to sleep at night. Is this ok? Not really. If your child is having difficulty sleeping, it is very important to discuss possible reasons with their doctor. Sleep aids, in general, are not effective as they don’t address the underlying problem causing insomnia. Now, if your child is itching so much from eczema or other causes then Benadryl® may be helpful to calm this down so they can rest.

I use Benadryl® for my child’s seasonal allergies. Is there a better option? Absolutely. Newer 2nd generation over-the-counter antihistamines such as loratadine, cetirizine, and fexofenadine (Claritin®, Zyrtec®, and Allegra®) last much longer (18-24 hours compared with 4-6 hours for Benadryl®) and have much fewer side effects, most notably sedation.

My child’s runny nose got better after taking Benadryl®. Does this mean they have allergies? Not at all. This is a prime example of how the side effects of Benadryl® can improve symptoms. Benadryl® can dry out secretions and mucous membranes. This can create problems not only in the eyes, nose and throat but throughout the rest of the body as well. Improvement in a runny nose during a cold is not due to the anti-histamine properties of the medication. In general, Benadryl® is not an effective medication to use during upper respiratory infections due to short duration of action and unfavorable side effect profile.

Can my child become tolerant to Benadryl®? Yes and no. If used excessively, the effectiveness may wear off over time. However, many other reasons for lack of efficacy exist, including using too low of a dose for their weight or using it to treat symptoms that it has no benefit towards.

Should I give Benadryl® for treatment of an allergic reaction? First line treatment of any severe, rapidly progressive allergic reaction (anaphylaxis) is self-injectable epinephrine. This is prescribed for children who have known food allergies or history of anaphylaxis and is not necessary for everyone to have. However, for mild symptoms such as rash or localized swelling without any breathing problems or other symptoms, Benadryl® can be very effective at reducing symptoms.

This is, by no means, a comprehensive list of indications for use or possible side effects but hopefully will answer some of your questions. As always, please talk to your child’s doctor if you have any questions regarding Benadryl® or any other medications. If you have specific questions about your child’s allergies, contact the Nationwide Children’s Hospital Allergy and Immunology Department.

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Dr. David Stukus is an Associate Professor of Pediatrics, Section of Allergy and Immunology, at Nationwide Children’s Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma. His personal life is filled with fun and chaos as he is married to a Pediatric Emergency Room physician and they have 2 energetic children. His rare free time is spent following his beloved Pittsburgh and Ohio State sports teams. Follow Dr. Dave on Twitter @AllergyKidsDoc for great allergy/asthma tips!

9 thoughts on “Benadryl®: Pros & Cons”

Our 6 year old daughter has allergies acting up recently. Claritin isn’t doing anything after a week. Yesterday our daughter had to go home from school due to her puffy face and a rash. We were wondering if in this case it might be worth a try to give her a Benadryl Children’s tablet before school in the morning – Diphenhydramine HCI (12.5 mg). We’ve given it to her on non-school days and there seems to be no drowsy side effect. Thank you.

Hi-From Dr. Stukus- I’m sorry to hear that your daughter is suffering this allergy season – spring can be very challenging for many people. Unfortunately, we cannot offer specific medical advice via this format or for anyone who is not a current patient. There are several effective options available to help treat allergy symptoms and a quick call to your daughter’s pediatrician will hopefully help you develop a good treatment plan. Best wishes.-Dr. Stukus

My 11 year old daughter takes focalin daily for adhd, and absolutely will not sleep at night. I mean to the point where she will be awake at 5 am. Even with no tv, no electronics, nothing. Her medicine keeps her up. One doctor told me it was ok to give her Benadryl, another said not to give her anything to make her sleep. I don’t know what to do. She needs sleep for school, and to be able to function healthy and properly. I’m at a loss.

Unfortunately, we are unable to offer specific medical advice through this forum but recommend that you continue to discuss these concerns with your daughter’s personal physician. Difficulty with sleeping is often a ‘side effect’ of some other health condition, medication, or behavioral habit, as you have already thought of. It would be worthwhile to discuss your daughter’s medication regimen to see if alternative medications, dosing, or formulations may be indicated. There may be other factors contributing as well, which can be discussed with her physician. Best wishes.

My 2yr old son suffers from hives still waiting on Dr to check blood work to see what is causing the hives he gets them daily, does not fail,. I have not been able to get him on any meds as of yet. So benadryl has been helping so much we usually give him Benadryl as soon as we see they are starting to appear. Im afraid that giving him Benadryl daily is not good for him but its the only thing that helps his hives go away… Until Dr finds what the actual cause is and be able to prescribe other meds.. now i have been giving him Benadryl daily( only when we see hives appear) once a day. Will/is this harming him. Its been 7 weeks now.

Unfortunately, we cannot offer specific medical advice in this forum. However, you should discuss more suitable treatment options, such as non-sedating second generation antihistamines, with your son’s doctor or consider referral to a board certified pediatric allergist, who can help assist in the proper diagnosis and treatment options for your son.